等离子双极电切联合球囊扩张导管对尿道狭窄患者性功能、排尿功能的影响

Effects of plasma bipolar electrotomy combined with balloon catheter on sexual function and urination in patients with urethral stricture

目的:探讨等离子双极电切联合球囊扩张导管治疗男性尿道狭窄的效果及对患者排尿功能、性功能的影响。方法:选取我院收治的100例尿道狭窄患者采用随机区组设计分为试验组和对照组各50例,试验组采用等离子双极电切联合球囊扩张导管治疗,对照组采用开放性尿道狭窄段切除端端吻合术治疗;对比两组的手术用时、手术出血量、下床活动时间、住院时间、手术前后的残余尿量、最大尿流率、平均尿流率、国际前列腺症状评分(IPSS)、国际勃起功能指数问卷-5(IIEF-5)评分。结果:试验组的手术用时、下床活动时间、住院时间、手术出血量均低于对照组;术前及术后,试验组和对照组的残余尿量、最大尿流率、平均尿流率组间比较,差异不具有统计学意义;术后,两组患者的最大尿流率、平均尿流率均较术前显著的提高,残余尿量均较术前显著的降低;术前,试验组和对照组的IPSS评分、IIEF-5评分差异不具有统计学意义;术后,试验组的IPSS评分和对照组差异无统计学意义,试验组的IIEF-5评分高于对照组。结论:等离子双极电切联合球囊扩张导管治疗尿道狭窄较开放性尿道狭窄段切除端端吻合术的优势在于创伤小、对患者术后性功能影响较小。

Objective To investigate the effect of plasma bipolar electrotomy combined with balloon catheter in the treatment of male urethral stricture and its effect on urinary function and sexual function.Methods A total of 100 patients with urethral stricture in our hospital were randomly divided into the experimental group and the control group with 50 cases in each.The experimental group was treated with plasma bipolar electrotomy combined with balloon dilatation catheter,and the control group was treated with open urethral stricture section resection and end to end anastomosis.The operative time,operative blood loss,time to get out of bed,length of hospital stay,residual urine volume before and after surgery,maximum urine flow rate,average urine flow rate,international prostate symptom score(IPSS),and international erectile function index questionnaire(iief-5)score were compared between the two groups.Results The operation time,the time of getting out of bed,ureteral indwelling time,hospitalization time and surgical bleeding were lower in the experimental group than in the control group.Before and after surgery,There were no significant differences in the residual urine volume,maximum urinary flow rate,and mean urinary flow rate between the experimental group and the control group.The maximum urinary flow rate and mean urinary flow in the two groups after surgery.The rates were significantly higher than those before surgery,and the residual urine volume was significantly lower than that before surgery.Before the operation,the difference between IPSS score and IIEF-5 score of the experimental group and the control group was not statistically significant.There was no significant difference in the IPSS score between the experimental group and the control group after surgery.The IIEF-5 score of the experimental group was higher than that of the control group after surgery.Conclusion The advantage of plasma bipolar electrotomy combined with balloon dilating catheter in the treatment of urethral stricture compared with the open end-to-end anastomosis of open urethral stricture is that the trauma is small and the effect on postoperative sexual function is small.